SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Bone Research
Comparative Analysis of Bone Density Measurement Techniques: A Systematic Review of Quantitative Ultrasound and Dual-Energy X-ray Absorptiometry
Provisionally accepted
- 1King Khalid University, Abha, Saudi Arabia
- 2Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia, Abha, Saudi Arabia
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Background: Measurement of bone mineral density (BMD) and bone-related parameters is es-sential for osteoporosis detection. Different screening modalities are used, including quantitative ultrasound (QUS) and dual-energy X-ray absorptiometry (DXA). This systematic review aimed to evaluate the correlation and clinical utility of DXA and QUS. Method: A literature search (2005–2025) was conducted in PubMed, Scopus, Web of Science, EMBASE, Google Scholar and Cochrane Library for English-language studies. A narrative syn-thesis was performed to summarize study characteristics and outcomes. Results: Of 1247 identified records, 24 studies met the inclusion criteria. DXA and QUS were used to assess bone parameters such as BMD, bone mineral content (BMC), speed of sound (SOS), broadband ultrasound attenuation (BAU), and stiffness index (SI). Correlation between DXA and QUS varied widely (r = 0.17–0.86), with variable diagnostic performance across studies. Studies involving postmenopausal women and elderly populations reported similar trends, whereas findings were inconsistent in pediatric and disease-specific populations. Conclusion: QUS is suitable for a preliminary screening, especially in resource-limited settings, but cannot replace DXA for definitive diagnosis. Further well design studies with longer follow-up are required to better define the QUS role in osteoporosis screening.
Keywords: Bone mineral content, bone mineral density, bone quality, DXA, fractures, Osteoporosis, Qus
Received: 29 Dec 2025; Accepted: 09 Feb 2026.
Copyright: © 2026 Hadadi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ibrahim Hadadi
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